Diffuse Idiopathic Skeletal Hyperostosis (DISH)

[dustybrown]

OK. I've posted this in nearly every related forum, but no one has answered my question. I am guessing because it's way too complex, or perhaps no one has heard of this condition. I certainly never have, but I am at my wits end in pain. I have so many diagnoses I feel like one of those people on that show called "Horders." It's ridiculous.

I had a cervical MRI from 1.5 years ago and finally got a hold of the report and was reading it. Perhaps someone could help me with some of the terms and give me your impressions??? I know that hypertrophy is arthritis, but I am not sure what "uncovertebral hyperostosis is? The report also said I have some encroachment onto the corresponding left C4-5 and C5-6 neural foramina. I also have bulging discs, and a bone spur found on my cervical spine on the left near the hyperostosis area.

I also have trouble with my lumbar spine- a bulging and torn disc, scoliosis, facet arthritis and degenerative facet disease, sciatica, and some nerve dysfunction that was proved through a nerve conduction test and an EMG. On top of this, I had a bone spur removed from my shoulder through a surgery and have had lots of episodes of tendinitis since my teen years.

I did some searching on the term "Hyperostosis" and only came up with information on a disease called "Forestier Disease" or Diffuse Idiopathic Skeletal Hyperostosis (DISH). Is anyone familiar with this? It seems to fit what's going on with me very well despite that fact that I am not male and in my 50's. I was worried for a long time that I had Ankylosing Spondylitis as my father has Reiter's Syndrome and I know that it's possible that I could have the gene that would make me susceptible to it (HLA-B27), but I've had doctors rule out AS already.

Every time I get a new MRI, I seem to degenerate more each time. My range of motion in my neck seems to be affected on one side. I have similar issues with my lumbar spine as well and I have lost feeling in my left foot. My Rheumatologist told me it's only going to get worse. Anyone have any ideas?

[reversvon]

It is difficult to find others with DISH;  We have started a grass roots search and currently have just under 100 ppl in a facebook group. Please feel free to join us there if it will help you out;  Tammy

[koala55]

Hi My name is Carolyn I live in sunshine coast in Queensland Australia I have D.I.S.H in my neck shoulder I have a lego block of calcification on my c4567 now all the discs in my neck are joining up . I find it hard to look up or down and to turn to the right I get numbness in my face in front of my right ear when I turn I get it up to my nose and down to my mouth . Some days I feel like I have had a stroke I have problems eating and drinking and with my voice. I am 55 and have had this for about 7 years it has started getting much worse over the last 12 months I have seen heaps of doctors but none of them want any thing to do with me as they all say it is to hard to fix my problem. Have you found a doctor that has worked with dish before ? I need help big time my local doctor is so worried about me and at her wits end as to were to send me as every one we try say the same thing.  thanks Carolyn

[dustybrown]

No worries. I know you are so very knowledgeable and experienced. I have read about the definition of "hypertrophy" being referred to as an enlarged organ. I just imagine my bones and spinal joints as being overgrown with arthritic calcification. It's painful and sometimes very hard to move my head. I hate it. I think I am slightly under medicated too, which doesn't help either.

Thanks for being so supportive as usual. I will let you know how the MRI and injection goes. Hopefully I'll know something more soon. Take care.
-Dusty

[Tuckamore]

Your physician is obviously correct that arthritis can cause hypertrophy but you can have hypertrophy from so many different reasons. The term hypertrophy does not mean arthritis. You can have an enlargement or overgrowth of an organ (hypertrophy) that has nothing to do with arthritis. But in your case, it terms of your joints I am sure they are hypertrophic from arthritis as your physician indicated. I did not mean to disagree with your her and hope I did not come across that I was. That is never my intention.

I am glad that you are going to have a new MRI. With your family history it is good to rule out Seronegative Spondyloarthropathies as well as investigate other possibilities. You also seem to have some early symptoms that may lead one to beleive you are also affected with one of these conditions.

The best way I can explain unconvertebral joints is to find it in the medical dictionary and let that explain it best. It states, "Uncovertebral joints are small synovial joint's between adjacent lateral lips of the bodies of the lower cervical vertebrae."  I hope that information helps.

I hope you will let me know the results of your MRI. I am saddened to hear that your pain has increased.  

Take Care,
Tuck

[dustybrown]

My Rheumatologist told me that in relation to the joints in my spine, hypertophy's definition is arthritis. I actually saw her last week and was asking her if there was a possibility that I had the same kind of arthritis in my neck as I had in my lower back. That is when she pulled out the old report of my cervical spine and said, yes indeed I did have arthritis (hypertrophy) in my neck. I asked for a copy of it and learned about the bone spur and the hyperostosis and some other stuff.

She is sending me off for a new MRI and an epidural injection in about a week. My neck and shoulder pain is so bad and my arms are so weak. She is sending me to a really good diagnostic radiologist who discovered a lot about my lower back when she sent me to him before. My last cervical MRI was done somewhere else.

I actually do not know what uncovertebral joints are though. That might make a difference in what my thinking is. I do know that DISH is considered one of the "Seronegative Spondyloarthropathies," which includes Ankylosing spondylitis and the disease my father had, Reiter's Syndrome. The issues that make me think this may have some validity are my recurring tendon involvement, bone spurs appearing, not only on my spine, but also on my shoulder and also my nerve damage in my lower spine. I suppose that could just be a part of DDD and natural osteoarthritis of the spine too, but geeezzz...this is painful and frustrating- especially being so young and falling apart.

I remember when I was 18 years old and I was suffering and my mom couldn't believe how much trouble I was having back then. I used to have to wrap my knees in ace bandages due to tendinitis and I was seeing an ortho doctor even back then. Crazy... Thanks for your help as always and sorry to be such a stranger. I hope you are doing ok. This weather has been a drag.
-Dusty

[Tuckamore]

It's good to hear from you again but not good that you have increased pain or problems. I'll try to answer some of your questions but as you know I am not an expert.

Hypertrophy is not arthritis. It is the increase in the volume of an organ or tissue due to the enlargement of its component cells. An excessive development of an organ or part or increase in bulk (as by thickening of muscle fibers) without multiplication of parts or exaggerated growth or complexity.

And I do find the same definition that you have found. Diffuse idiopathic skeletal hyperostosis (DISH) is calcification or a bony hardening of ligaments in areas where they attach to your spine.

I also found this: "As a consequence of increasing degeneration of intervertebral discs in patients with degenerative disease of the spine, the uncovertebral joints may undergo degeneration and produce radiculopathy. Plain radiographs and CT scans are useful in diagnosing the abnormal relationships resulting from disc degeneration, which often lead to hyperostosis of the uncinate process and adjacent vertebral body. Erosions may also be evident. In some cases narrowing of the neural foramen with spinal nerve compression or impingement on the vertebral artery occurs."

If you note they use the terms Uncovertebral joint and hyperostosis. It is my guess that the radiologist left out the word joint because it was understood. If you know what I mean. I do not think that this report indicates you have DISH.  In my opinion this is the result of DDD. But again I am guessing based on my background.

I can do some more searching later this evening to see if I can come up with better answers for you. Possibly our members will have more information for you.

Is this your most result scan results?